Nigeria’s health system is functioning at only 45 per cent capacity, well below the African regional average of 56 per cent, according to a new report by the African Health Observatory Platform on Health Systems and Policies (AHOP).
The findings were released in the maiden edition of the Country Health System and Services Profile (CHSSP) for Nigeria, published by the Health Policy Research Group, University of Nigeria, Nsukka, with support from the Federal Ministry of Health and Social Welfare and the World Health Organization–African Region (WHO-AFRO).
The report, signed by Prof. Obinna Onwujekwe, Director of Nigeria’s National Centre for AHOP, will be officially launched on October 8 in Abuja.
Prof. Onwujekwe said the assessment showed that Nigeria’s health outcomes have failed to reflect years of reforms and spending, with government expenditure on health still among the lowest in Africa.
Weak outcomes despite reforms
The report noted that while access, demand, and quality of health services have improved over the past decade, progress remains insufficient to achieve universal health coverage by 2030.
Nigeria’s coverage of essential services is still 1.7 per cent below the regional average. Private providers dominate the sector, delivering 70 per cent of services, even though they account for only 35 per cent of health facilities.
Infrastructure and spending gaps
The report highlighted that about 80 per cent of health infrastructure in Nigeria is dysfunctional, a situation that fuels outbound medical tourism and costs the country an estimated $1 billion annually.
It also revealed that out-of-pocket payments account for 75 per cent of health spending, with just one in ten Nigerians having access to health insurance or risk-pooling mechanisms.
Human resource challenges
Nigeria has 3.95 doctors per 10,000 people, higher than the regional average of 1.5 but still below the recommended 4.45 threshold. Only 51 per cent of childbirths are attended by skilled personnel, leaving many women and newborns vulnerable.
The report linked the country’s underperformance to chronic underinvestment, weak infrastructure, and poor utilisation of health workers.
“Nigeria spends less on health as a share of GDP than nearly every other country in the world, leaving most of its poor and vulnerable population exposed to catastrophic health costs,” the report stated.
It added that bridging the performance gap will require effective implementation of the National Health Insurance Authority Act 2023 and the Basic Health Care Provision Fund (2014).
